| National Provider Identifier [NPI]: | 1558469155 |
| Last Name Of The Provider | AMMANN |
| First Name Of The Provider | SUNNI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | P.A.-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 241 W WEAVER RD |
| Street Address 2 Of The Provider | SUITE 145C |
| City Of The Provider | FORSYTH |
| Zip Code Of The Provider | 625359762 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 761 |
| Number Of Medicare Beneficiaries | 379 |
| Total Submitted Charge Amount | 204581.9 |
| Total Medicare Allowed Amount | 49445.71 |
| Total Medicare Payment Amount | 36914.22 |
| Total Medicare Standardized Payment Amount | 44097.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 189 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 2953 |
| Total Drug Medicare AllowedAmount | 445.52 |
| Total Drug Medicare PaymentAmount | 392.52 |
| Total Drug Medicare Standardized Payment Amount | 392.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 572 |
| Number Of Medicare Beneficiaries With Medical Services | 379 |
| Total Medical Submitted Charge Amount | 201628.9 |
| Total Medical Medicare Allowed Amount | 49000.19 |
| Total Medical Medicare Payment Amount | 36521.7 |
| Total Medical Medicare Standardized Payment Amount | 43704.8 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 161 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6193 |